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DOL Issues New Recommended FMLA Forms

The U.S. Department of Labor has released new and revised versions of its model notice of rights, certification and designation forms under the FMLA. The DOL seeks to simplify and make it easier for employees, employers, leave administrators and health care providers to understand the new forms, which can be found on the DOL's website.


The revisions don't alter the substance of leave benefits and protections but include more questions that can be answered by checking response boxes instead of writing responses. There are also changes to the Notice of Eligibility & Rights and Responsibilities forms. The Society for Human Resource Management points out the older version was organized by rights and responsibilities. The new version is organized by topic.


The revised certification forms offer the circumstances in which follow-up data may be obtained from health care providers. The forms are reorganized to more efficiently determine what can be considered a serious health condition.

And in the current quarantined world, the forms now include electronic signatures for contactless completion and transmission of completed forms. However, employers are still required to post the FMLA notice in the workplace despite the coronavirus sending many employees to work from home.

The use of the DOL's model forms is optional — applicants and companies can see them as templates. Also, because the FMLA requires specific forms to be used, employers can't require employees to provide a new certification using the updated forms if they've already provided the required FMLA information on prior versions of the forms unless recertification is otherwise required, according to regulations.

Among the changed forms are:

  • WH-381 — Notice of Eligibility & Rights and Responsibilities.

  • WH-382 — Designation Notice.

  • WH-380-E and -F — Certification of Health Care Provider for Employee's or Family Member's Serious Health Condition.

The changes lend greater clarity to the information provided on each topic. The DOL aligned the Notice of Eligibility & Rights and Responsibilities form more closely with leave regulations, including:

  • Requiring an employer to indicate how far short of the 1,250 hours of service requirement a worker is if he or she doesn't meet that eligibility criterion. The DOL notes that the 1,250-hours/12-month minimum is one of the requirements for an employee to be eligible to take leave.

  • The option for you to indicate the effect that FMLA leave has on employee benefits other than health insurance.

  • Whether FMLA leave will run concurrently with workers' compensation, any applicable disability insurance coverage or leave required by state law.

FMLA provisions can be complicated, especially now during the pandemic, when more employees than ever need various kinds of leave because of their own illnesses, the illnesses of close family or the need to take care of children in the absence of schools and child care. Both employers and employees should seek professional advice to make sure they understand both their rights and responsibilities in these difficult times.

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